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We aimed to investigate the change of serum metabolomics in response to n-3 fatty acid supplements in Chinese patients with type 2 diabetes (T2D). In a double-blind parallel randomised controlled trial, 59 Chinese T2D patients were randomised to receive either fish oil (FO), flaxseed oil (FSO) or corn oil capsules (CO, served as a control group) and followed up for 180 days. An additional 17 healthy non-T2D participants were recruited at baseline for cross-sectional comparison between cases and non-cases. A total of 296 serum metabolites were measured among healthy controls and T2D patients before and after the intervention. Serum 3-carboxy-4-methyl-5-propyl-2-furanpropanoate (CMPF) ( P -interaction = 1.8 × 10 −7 ) was the most significant metabolite identified by repeated-measures ANOVA, followed by eicosapentaenoate ( P -interaction = 4.6 × 10 −6 ), 1-eicosapentaenoylglycerophosphocholine ( P -interaction = 3.4 × 10 −4 ), docosahexaenoate ( P -interaction = 0.001), linolenate (n-3 or n-6,  P -interaction = 0.005) and docosapentaenoate (n-3,  P -interaction = 0.021). CMPF level was lower in T2D patients than in the healthy controls ( P  = 0.014) and it was significantly increased in the FO compared with CO group ( P  = 1.17 × 10 −7 ). Furthermore, change of CMPF during the intervention was negatively correlated with change of serum triglycerides ( P  = 0.016). In conclusion, furan fatty acid metabolite CMPF was the strongest biomarker of fish oil intake. The association of CMPF with metabolic markers warrants further investigation.

Serum metabolomics profiles in response to n-3 fatty acids in Chinese patients with type 2 diabetes: a double-blind randomised controlled trial